title: Repair of multiple finger defects using the dorsal homodigital island flaps.
abstract: BACKGROUND
  Providing soft-tissue coverage for multiple finger defects remains a challenge for the hand surgeons. This article reports reconstruction of multiple digital defects using the dorsal homodigital island flaps based on the dorsal branch of the digital artery.
  
  
  METHODS
  Over 3 years, a retrospective study was conducted with 12 patients who had multiple finger defects treated with the dorsal homodigital island flaps. Our series included nine male and three female patients. There were 30 soft-tissue defects in 30 fingers. The injured fingers included seven index, nine long, nine ring and five little fingers. The average size of soft-tissue defects and flaps was 2.4 ± 0.4 cm × 1.7 ± 0.2 cm and 2.6 ± 0.4 cm × 1.9 ± 0.2 cm, and the mean pedicle length was 1.1 ± 0.2 cm.
  
  
  RESULTS
  Full flap survival was achieved in 26 fingers. Partial distal flap necrosis was noted in four fingers, which healed without surgical intervention. At a median of 20 (range, 19-23) months' follow-up, the static two-point discrimination on the flap averaged 9.1 ± 1.6 mm, and the median (range) Semmes-Weinstein monofilament score was 3.84 (3.84-4.17). The donor-site morbidity was accepted. According to the Michigan Hand Outcomes Questionnaire, seven patients were strongly satisfied and five were satisfied with functional recovery of the reconstructed fingers.
  
  
  CONCLUSIONS
  The dorsal homodigital island flap, based on the dorsal branch of the digital artery, is less invasive, versatile and technically easy for simultaneous coverage of small-to-moderate defects in multiple fingers.
authors.affiliation: Hand Surgery Department, The Second Hospital of Tangshan, Tangshan, Hebei 063000, PR China; Affiliated Hospital of North China Coal Medical College, Hebei United University, Tangshan, Hebei 063000, PR China. Electronic address: ts_chenchao@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Li
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000098:blood supply / Q000294:innervation* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D012677:Sensation; D017695:Soft Tissue Injuries / Q000503:physiopathology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Dorsal branch of the digital artery; Dorsal branch of the digital nerve; Dorsal homodigital island flap; Multiple finger defects